The Role of Endoscopy in Dyspeptic Syndrome in Children and Adolescentes

Abstract

Background Dyspepsia is pain or discomfort in the epigastric region, and can be subdivided into organic and functional. The diagnosis of functional dyspepsia is based on the criteria defined by the Rome committee. In the pediatric population, functional dyspepsia is more common than organic dyspepsia, in addition to being part of a set of diseases called defined gastrointestinal disorders, defined by the Rome IV criteria. The most efficient diagnostic method of functional dyspepsia in the pediatric population is still uncertain since endoscopy is an important test to rule out organic changes, but it is invasive to be performed on a large scale. Objective To evaluate the role of endoscopy in the diagnosis of functional dyspepsia in pediatric patients, aiming at preventing invasive procedures and reaching high specificity in the result, which is important to determine the best diagnostic guideline for these patients. Methods: Narrative literature review study performed by searching for articles in the PubMed/Medline and LILACS database using the PRISMA method. Results A total of 102 articles were found in PubMed, 15 of which were selected for the study. In the LILACS database, nine articles were found and one was selected. Thus, 16 articles were selected for the study. The most appropriate indications for endoscopy, how to differentiate organic from functional dyspepsia without endoscopy, the main endoscopic findings of the studies, the differences between Rome III and Rome IV criteria, and the prevalence and factors possibly associated with functional dyspepsia were approached through the selected articles. Conclusion The main indication for endoscopy is the presence of alarm symptoms in pediatric patients with dyspepsia and the Rome clinical criteria are efficient for the diagnosis of functional dyspepsia. However, there is still no standardized diagnostic guideline to be followed in this age group.

Characteristic of patients with abdominal pain referred to pediatric gastroenterologist and pediatric rheumatologist

“…En uygun endikasyonlar; çocuğun ailesinde peptik ülser ve/veya H. pylori öyküsü, ailede inflamatuar barsak hastalığı öyküsü ile alarm semptomları olan istemsiz kilo kaybı, büyüme geriliği, belirgin kusma, kronik ve belirgin ishal, Gİ kan kaybı, sağ üst veya alt kadranda kalıcı hassasiyet ve açıklanamayan ateş olarak vurgulanmıştır. 23 Bizim çalışmamızda hastaların yaklaşık üçte birine endoskopi yapılmıştı. Bu hastaların çoğunluğunda nonspesifik gastrit saptandı ve patoloji de nonspesifik inflamasyon bulguları vardı.…”